By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

Intertriginous dermatitis (ITD), also referred to as intertrigo, is an inflammatory condition that affects opposing skin surfaces and can occur anywhere on the body where two surfaces are in contact. For example, the pannus or abdominal skin folds, inner gluteal cleft, and axillae are some common anatomical locations of ITD. Intertrigo is seen across care settings and is increasingly common in patients with diabetes, patients with obesity, and patients who need assistance with hygiene or self-care activities of daily living. ITD is thought to be caused by a combination of two factors: moisture trapping or overhydration of the skin and friction between opposing skin folds (skin rubbing against skin for a prolonged period of time). ITD may manifest as a linear tear at the base of a fold or a linear open area within an area of macerated skin. Tears may result from stretching of overhydrated or moist skin during routine skin assessments or from friction with cleansing.

Diabetic foot ulcers (DFUs) may affect up to 25% of people with diabetes at some point in their lifetime. Once a person has developed a DFU, there is a 50% chance the ulcer will become infected. DFUs are also among the leading causes of amputation.2

By Steven A. Kahn, MD

When treating severe burns, surgeons generally consider eschar removal to be the major factor and the top challenge in both initiating and planning for the optimal course of treatment for each patient. Before grafting, all devitalized tissue must be removed, leaving a wound bed of only healthy tissue. Some burn wounds are clearly full-thickness on initial examination, and some are clearly superficial, with relatively straightforward decision making. However, some wounds have an indeterminate depth and are more challenging. Deep partial-thickness, indeterminate-, and heterogenous-depth wounds require more complex decision making and/or a protracted interval to allow the wound to declare. Eschar removal is sometimes necessary to allow surgeons to assess the wound bed and confirm the depth and severity of certain burns. This, in turn, provides the insights a surgeon needs to determine the best course of treatment, including whether a patient must be treated with an autograft to cover a wound area.

The digital age is upon us, like it or not, ready or not. For the past few years, payers have incentivized, encouraged, reimbursed, and adopted various digital, remote monitoring systems and devices as a way to encourage providers to adopt more digital, remote methods. Although complete telehealth services were not reimbursed in all care settings in all Zip Codes by all payers throughout the United States at the beginning of 2020, many of the restrictions and barriers to provide nearly complete digital services were suddenly released in response to the needs of a nation in the throes of a pandemic.